It used to be, not too long ago, that if you wanted medical information you needed to go to the medical library, wander through the stacks, find the appropriate medical book or journal, and then spend hours scouring through them until you found the right source. For patients it was even worse. They had to ask a doctor they trusted and hope for the right answer or physically go to the same medical library and pour through the same journals without any of the language, context, or experience of reading journals.
Today, it is so much better. Or is it?
Medical information today is ubiquitous -- in just seconds you can find almost everything about anything and you don't even need to move beyond your keyboard. There are multiple websites, TV shows, radio shows, seminars, and tweets about health care and medicine. And there are so many people willing to offer their views on your medical questions, not just doctors. Alternative practitioners, relatives, teachers, actors, friends and even the check-out guy at the health food store all have information readily offered with some degree of credibility regardless of its accuracy.
So, to help navigate, I'd like to offer some suggestions on how to become a serious consumer of medical information.
It might be helpful, first, to understand how the medical community learns and how it acquires and adopts new information. Amongst the various classes and language acquisition inherent in medical school (20,000 new terms learned in the first four years of medical training) we had a one-week class on reading medical literature. I can literally remember rolling my eyes, not believing that we would be spending an entire week on "reading." It turned out to be one of the most useful weeks of medical school.
First of all, it is important to note that reputable journals such as the New England Journal of Medicine do not publish articles because they are true. They publish them because they are interesting; they present a new idea, confirm or refute an old one, or just provide insight to a perplexing issue. Before publication, the articles are reviewed intensely by experts in the same field. The editor often will send the article back for extra work, better statistical analysis and more complete conclusions. Only then will they be published and shared with the rest of the medical community. Then, as physicians worldwide have the opportunity to review and comment, the articles go through another scrutiny in the "letters to the editor," often with comments by groups doing similar research and by physicians sharing their real world experience. Finally, other groups of physicians in the field may submit their papers that continue the process of affirmation or disputation. Then, and only then, will the body of medical knowledge be amended.
It takes the observation and comments of many to fine tune new ideas, a process that can take years.
Popular media, unfortunately, often take these articles as fact and publish them as though they are true. Sometimes they turn out to be that way but often things will change with time. The difficulty in being a lay consumer of this information is that it can be hard to follow all of this information and even more difficult to put into practical context.
A significant percentage of information currently known as standard of care will one day be proven to be incorrect. A significant percentage of information currently viewed as quackery will one day be standard of care. It is almost impossible to know in advance how these will play out.
So here is my list of how to look at medical information:
1. When reviewing medical journals, they should only be peer-reviewed journals such as The New England Journal of Medicine, The Journal of the American Medical Association and Pediatrics.
2. Use reliable websites such as:
The American Academy of Pediatrics
The Center for Disease Control
3. If you want to buy a product, vitamin, treatment, etc., investigate the reviews and ensure that they are independent, and not provided by the company. Apply the at least the same due diligence as you would to products approved by the FDA.
4. Corroborate the sources for accuracy and honesty.
Remember that one does not need to tell the truth to write something on a website. But with some time, dedication and serious attention it is possible to glean accurate information from the web.
Happy hunting!
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